Origins of Addictive Behavior: A Nature Heritage
or a Neuropsychiatric Nurtured

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ARTICULO DE REVISIONOrigins of Addictive Behavior: A Nature Heritage or a Neuropsychiatric Nurtured Reality?Luis Maia, PhDAbstractIn this paper we present a revision on the origins of Addictive Behavior and related neural basis. Although there are abundant specific bibliography and professions focusing on addictions treatment, the reasons why people started with addictive behaviors and consequently maintain are still not well understood. This article explores the construction, meaning, and impact of addiction in histori-cal and psychological perspective. The challenge to the usual concept of addictions causes has significant implications for medical practice and for treatment programs. Furthermore, with this article we present the phenomena of Multifactorial Polygenic Heritage as a possible theory for the explanation of addictive behavior, being consequently important for its prevention and treatment. The roles of social, cultural, and population differences, as they may relate to addictive behaviors, are explored. Keywords. Electroneurography. Electromyography. Nerve injury. Accessory spinal nerve.Keywords: Addiction; Vulnerability; History of Drugs, Neuropsychiatry of DrugsResumenEn este documento presentamos una revision sobre los origenes del comportamiento adictivo y sus bases neurales. Aunque hay abundante bibliografia especifica y profesiones centrandose en el tratamiento de adicciones, todavia no se entienden bien las razones por lo que las personas comenzaron con comportamientos adictivos y los mantienen. Este articulo explora la construccion, significado e impacto de la adiccion en una perspectiva historica y psicologica. El desafio para el concepto habitual de causas de adicciones tiene importantes repercusiones para la practica medica y para los programas de tratamiento. Por otra parte, con este articulo presentamos los fenomenos del patrimonio poligenico multifactorial como una teoria posible para la explicacion del comportamiento adictivo, con consecuencias importantes para su prevencion y tratamiento. Las funciones sociales, culturales y las diferencias de poblacion, en lo que se puede referir a comportamientos adictivos son explorados.Palabras clave: Adiccion; Vulnerabilidad; Historia de las Drogas; Neuropsiquiatria de las Drogas.ResumoNeste artigo apresentamos uma revisao sobre as origens do comportamento aditivo e as suas bases neurais. Embora haja abundante bibliografia especifica, bem como profissoes no campo, enfocando o tratamento de dependencias e os motivos que levam as pessoas a ini-ciarem os seus comportamentos de adicao e, consequentemente, mante-los, estes ainda nao sao bem compreendidos. Este artigo explora a construcao, significado e impacto da dependencia numa perspectiva historica e psicologica. O desafio ao conceito usual de causas de dependencias tem implicacoes significativas para a pratica medica e para programas de tratamento. Alem disso, neste artigo apresenta-mos os fenomenos da Heranca Poligenica Multifatorial como uma possivel teoria para a explicacao do comportamento de dependencia, sendo consequentemente importante para a sua prevencao e tratamento. Sao ainda explorados os papeis sociais, culturais e as diferencas de populacao, bem como eles podem incidir sobre os comportamentos de dependencia.Palavras chave: Adicao, Vulnerabilidade; Historia das drogas; Neuropsiquiatria das DrogasRev. Ecuat. Neurol. Vol. 19, No 1-2, 2010 Auxiliar Professor - Beira Interior University - Portugal. Correspondencia:Clinical Neuropsychologist, PhD (USAL - Spain)Clinical Psychologist (Minho University - Portugal)Neuroscientist, MsC (Medicine School of Lisbon - Portugal)Beira Interior University, e-mail: [email protected]Medico Legal Perit (Medicine Institute Abel Salazar - Oporto, Portugal)Graduation in Clinical Neuropsychology (USAL - Spain)Graduation in Investigative Proficiency on Psychobiology (USAL - Spain)Clinical Psychologist (Minho University - Portugal)Beira Interior University, e-mail: [email protected]64 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010Introductiondepressing effect had just been discovered". In its review, The term "addiction" was initially used by medical the authors suggest that Ethanol was the first substance and moral authorities as a medical condition to charac-intentionally used in order to make surgery possible. As terize what was till that time denominated of "habitual example of that, they state that ethanol was the only anes-drunkenness", used in the late 18th century.1-2 The term thetic drug (in form of wine) used by barber-surgeons addiction did not exist before that date and rapidly evol-from the Napoleonic army, that invaded Russian in 19th ved for the field of actual illegal drugs, which at that time Century. This therapeutic utilization was interrupted be-were the only drugs used in the majority of the fields of cause the non-significant therapeutic index and problems medicine, like the opiate morphine, in the case of Vete-in intentionally awaking patients, and culminated with rans of America Civil War (1861-1865). The terminology the interruption of these procedures in the early 20th "Addiction" is currently used as a general term to cover Century. up a subject with a number of other expressions particu-In terms of curiosity, these inebriating and amne-larly "alcoholism"; and well before, "inebriety," in the ex-sic effects served as the basis for the first written known tended records of talking with reference to alcohol; and description of an incest relation between Lot (Abraham's "dependence," in contemporary nosologies.3 nephew) and his two daughters (altogether they have The most widespread psychoactive drug used by left from Sodome).8 From these relationships Moabite mankind, since ancient and biblical times is alcohol, and and Amanite tribes originated. According to the authors a simple glance in the Old Testament demonstrate the this lascivious effect of alcohol to facilitate rape was importance in psychological effects, and even in terms replaced by the benzodiazepine flunitrazepam (Rohip-of genetic influence, as well as moral, environmental and nol), legally banned in several countries (although they so forth.4,5 Alcohol and opiate substances were the first have been first developed as benzodiazepine drug used psychoactive substances used with this purpose around as a hypnotic and in anesthesia), because its capacity to 5,000 year B.C.6 The deleterious consequences of alcohol cause semiconciousness and memory blackouts (several abuse or misuse were well recognized in the prehistoric unwanted sexual encounters were reported by victims of age, and it took mankind a long time to make any real sexual assault under the influence of this drug).8 As ano-progress in providing help to those individuals who were ther example of anesthetic effect of alcohol they quote the affected.4 The production of alcohol is the oldest of all Book of Marc 15, "And they gave him wine mixed with intentional psychoactive drugs production. In the same myrrh; but he did not take it", the refuse from Jesus was way, the historical searches indicate that fermentation considered as a refuse of the anesthetic effect of alcohol, of some fruit or honey is the first remote origin of the preferring to suffer the pain of crucifixion from 9:00 a.m. first psychoactive agent. Archaeological discoveries re-to 3:00 p.m. in the Golgotha hill. veal that pieces to production and consumption already Pulque is, probably, the oldest fermented drink in pre-existed 8.000 b.C and that, at least, in 5.000 B.C. they Hispanic Mexico.9 The culture of the Maguey (a variation were used to store honey; it is deduced that honey were of Pulque) is almost as old as the origins of agriculture fermented and diluted in water (mead or hydromel) and in America. There are testimonies that inform on the cul-has been the first wine for human consumption.7ture of the maguey in the zone of Tehuacan towards year Alcohol utilization has been well described in seve-6 500 B.C. Its utilization was strictly reserved to ritual ral passages of the bible and has been used as inhalational purposes and only by tribal leaders or sorcerers, being anesthesia, hypnosis and amnesia, chronobiology, among its utilization by ordinary people severely repressed. In other.8 From the Bible Book of Proverbs (p. 123) they quo-equal way the earliest confirmed evidence for wine dates te the Proverb 20: "Wine makes men foolish and strong back to 5.000 B.C. This evidence is in the form of tartrate drink makes men come to blows", as well as the Book of deposits on a pot from the Zagros Mountains of Iran. It is Genesis, 19, "And that night they made their father take questionable whether wine could precede this discovery much wine. . and the older daughter went into his bed; by more than a thousand years as it, perhaps, required the and he had no knowledge of when she went in or when advances in pottery which took place at this time. Before she went away and so the two daughters of Lot were with this discovery, the oldest confirmed evidence for grapes child by their father". within human settlements was in pips from wild vines da-Parting from these passages, some authors made se-ting from c 4500 B.C.10 Some claim that there is evidence veral extrapolations. They state that probably some gra-for cultivated grapes dating back to 8000 B.C, in the so pes were left in some place, like a hole in a rock, about called Noah Hypothesis, although there is no evidence to 6,000 years ago.8 Progressively, "they deteriorated and relate findings of this period to cultivated varieties and became a viscous mass, under the action of the sun and also, the evidences found are so few as to make this date invisible creatures (yeasts), which quenched the thirst doubtful.10 Like the historian Edward Gibbon, affirm that of some primitive hungry man... alcohol's stimulating-wine search was one of the reasons that had taken the Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 65Barbarians to invade the Europe.11 Also, Grapevine is the I B.C. introduces in his "triaca magna" and many great most cited plant in the Bible and the first miracle of Jesus contemporary men used it with therapeutic aims like em-was to convert water into wine in the weddings of Cana-peror Marco Aurelio who used it to calm his migraines.an; also The Mediterranean armies, since the antiquity, After a period of relative silence on its use, in the age it had always drunk wine; The Justinian Code prescribed mediates the Arabs (who never let use it) spread the use posca, sour wine and water, as part of the ration of the of opium by all its occupied territories, being known that soldiers; The drunkenness of Alexander, the Great, and Avicenna dies intoxicated by himself in 1037.14 In Middle of its father, Filipe, became famous and proverbial; Pas-East, where he was very employed by medicine, it was sed two millennia, and the Napoleonic armies continued extended towards India and, later, in century IX, until to receive wine; one hundred million liters had been more China, while in western Europe the opium acquired the-than bought for the French soldiers; In World War II the rapeutic importance in century XVI, after the trips of the military ration of the Frenchmen arrived up to one liter doctor and Swiss alchemist Paracelsus, whom its spread daily; But in the year of 1917, the French army bought for diverse aims in laudanum form or in tinctures.12 Ini-120 million liters.11tially, in China, Opium was used orally as medicine, and Other remarkable categories of agents that modify in the later century XVII, the consumption of smoked states of minds are vegetables, or herbal varieties, like opium became popular in that country.7 The consumption plants. For instance, people from the Waley of Rivers was increased in an alarming form and the internal pro-Tigres and Eufrates (3.000 B.C) consumed Amapola (a duction was not sufficient, so that in century XIX, 16.2 plant) to produce euphoria and "well-being" (the same million Chinese citizens was addicted to smoked opium plant was reported in India, 1500 B.C, as a "wonderful (6% of the adult population).2 In China opium was well-plant").9 Hallucinogenic Solanaceae use, like Belladon-known from century VIII although it began to be used na, Datura and the Mandragora, goes back to old testimo-to obtain medicine as a result of its introduction by the nies of Middle and Far East; in Europe, they were bound Arabs in Asia towards centuries IX and X.14 However, it traditionally with witchcraft, being used in ceremonial was not but towards the century XVI that next to the in-and therapeutic contexts. Levitation phenomena are attri-troduction of the use of tobacco by the Dutch and Portu-buted to them, as well as telepathy and fantastic physical guese sailors that gradually opened the doors to its con-feats. In Eurasia the muscaria amanita, a psychoactive sumption like means of enjoyment and pleasure, which fungus used by shamans of Siberia in its rituals was very locates in century XVIII with an intense commerce of abundant.12 The opium, juice of a type of poppy, is one opium with India.14 The business was served and thus the of the most known versatile drugs; due its active ingre-British Empire begins to monopolize the transaction of dient, morphine, the opium induces lower pain, produces opium in Asia being happened to sell 300 Tons in 1821 joy, induces dream and reduces afflictions; the plant of to more than 3000 Tons in 1848. According to several the poppy, well-known like narcotic, always was used authors the attempt to restrain the opium commerce ge-like food, forage and oil, but there are historical regis-nerated two successive wars (1839-1842 and 1856-1858), tries which their psychotropic functions already were between England and China, culminating with the Chi-known in 3.000 B.C.13 The first written signs of Opium nese defeat and the obtaining of a series of privileges on existence as a plant and its use overcome to the Sume-the part of England, as the complete legalization of the rian times 3000 years B.C, although it is not but in the commerce of Indian opium and the loss of the adminis-Ebers Papyrus in century XVI B.C where is found for the tration of Hong Kong.2,7first time the reference to opium name in a product list In equal way, in Europe, in the heat of century XIX, of medical effects, with the following indication: "For Opium spreads slow but inexorably wrapped by an im-children who shout too much hard."14 Also, the Greek portant tolerance and animated by intellectuals and es-culture knows the plant entirely and therefore Hesiod in sayists: Quincey, Musset, Coleridge, Dickens, Scott, Poe, century VIII previously mentions it in his works, and cite Baudelaire, Gautier, Balzac, and thus one releases list Morpheus (that in century XIX would give name to Mor-of illustrious guarantee it; so that in the XX the spirit phine), and until in the very same Odyssey appears the follows: Apollinaire, Modigliani, Toulouse-Lautrec, Pi-"Nepenthes" like the "drug of the forgetfulness."14 Howe-casso and thus until the stubborn defense that in 1929 ver, the principles of their systematic use are tie logically makes Cocteau in its work "Opium".14 The purification to Hippocrates, Herodotus and Theophrastus in century of opium alkaloids, that already the doctors of Napoleon, III B. C., time in which already begins the controversy Derosne and Seguin, plus the invention of the syringe by (that would never leave to us) on the medicinal double Pravaz, causes that morphine extends like the analgesic slide and of dangerous substance.14 Additionally, the Ro-powder like in all the Wars (Crimen, American Succes-mans, heirs of the Greek culture, know, indicate and use sion, etc.), and also by the richer social layers of Europe, the Opium with naturalness, and thus Galen in century where the equipment of injection for morphine becomes 66 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010sophisticated models of last fashion and the books on the islands, Mexico, Central America and Brazil smoking wonders of the injection are multiplied.14 From this to its tobacco rolls. In a wake of Uaxactun, Guatemala, that generalized prohibition in almost the entire occidental dates from century X is the figure of a Mayan priest smo-world was jus a little step.king, who demonstrates that the use of tobacco was well Other famous hallucinogens have also millenarian established long before the discovery of America, which foundation. In America, the old indigenous civilizations also was confirmed by Sahagun.20 The Indians of North also had the custom to use hallucinogenic plants in their America also smoked, in the region of Ontario in a zone ceremonies. After century X, B.C. there is stone-fungus called Tionontati (Tobacco Nation).20 In Europe tobacco between monuments of Izapa culture (actual Guatemala), was first described in Chronicles of Colombian discove-as well as in Peru (pipes of ceramics of century IV B.C. ries as well as India's adventures. Gonzalo Fernandez de with a figure of peyote, an hallucinogenic cactus that Oviedo y Valdez (Historia General de las Indias, Sevi-contains mescaline).12 Thus Peyote fungus whose active lla, 1535), states "Among other reprobables customs the principle is mescaline, goes back to the pre-Columbian Indians have one is specially injurious and that consists American civilizations, and later its use is even very of the absorption of a certain class of smoke to which wide-ranging among North American Indians (Mescale-some call "tobacco" to produce a stupor state (. .) absorb ros Apaches, Comanches Kiowas and Cheyenes); Aldous the smoke by means of a hollow cane, that is what the Huxley, being one of the last intellectuals in proving it Indians call "tobacco" and not to the grass".18 Also, Co-and spreading it to the own, in his book "In the doors lumbus was surprised by the use of tobacco in religious of the perception" describes the effects of the hallucino-and social ceremonies, like those of peace and purifi-gen in itself.15-16 Peyote, for the Indians was something cation of the spirit, because for the Indians the tobacco religious, mythical, that the same provided invulnerabi-had magical powers and pleased the Gods. Tobacco was lity sensation that served to discover distant and hidden considered a panacea, since it was used to fight the as-things; its main alkaloid is the mescaline, that produces thma, the fevers and convulsions, the intestinal and ner-an own dissociative syndrome like in schizophrenics, ori-vous upheavals and bites of animals.18 There are reports ginating chromatic visions and hallucinations.17that supports that early in 1560 A.C. tobacco was known The relation between witches with ointments (drugs) in Spain and Portugal. The author stresses the origin of is a constant since an interrelation its supposed and was the name Nicotine. According to him, the ambassador of appraised and the spoor that suffered; one of the first that France in Portugal, Jean Nicot, was interested in the use occurred account of this was doctor Andres Laguna and of the plant and when he returned to its country he took more recently it has been shown by M.J. Harner, that has tobacco leaves with himself to offer to queen Catherine studied thorough the ointments that used, reaching the de Medicis. For that reason, tobacco was called "grass conclusion that if not all, the majority contain atropine, of the queen", "nicotiana" or "grass of the ambassador". powerful alkaloid at least; the cane or broom on which Catherine de Medicis suffered from strong migraine and many witches said to fly served to apply the plants that the ambassador recommended taking the plant inhaling contained it to the sensible vaginal membranes and that it by the nose. The pains disappeared and the tobacco that alkaloid produced a deep lethargy to those who of began to be used like medicine in France and the rest of them were worth, to the way of our present drugs - "trips" Europe. When Linnaeus published its Species Plantorum, also denominate the artificial paradises in which the drug he chose the scientific name of Nicotiana tabacum in tri-addicts submerge day today is something in which they bute to Nicot.18 In 1584, Walter Raleigh founded on North agree who approach the subject with rigor and serious-America the colony of Virginia, copied from natives the ness.17custom to smoke in pipe and the culture of the famous The popular nicotine also has some remarkable evi-tobacco in Virginia, that was introduced in England in dences. The acclimatization of the plant Nicotiana ta-Isabel the Ist Era.18 The possible therapeutic virtues of bacum in Cuba was developed by the aravacas Indians tobacco, took the conquerors of Hispanic America to 2,000 years old before Christ.18 Although some authors transfer the seeds for their culture to the old continent at have affirmed that it was already present in the old or-the beginning of century XVI; the Spaniards also took ganizations of the east, their most known origin is the their culture towards Prusia and Philippines (from where American, being accepted that the first culture in using he moved towards China) and the Portuguese scattered it tobacco leaves to smoke them was the Mayan, from by Africa, Italy, Iran, Java, India and Japan.2 Rapidly to-2,000 B.C.19 bacco become the main economic resource of the English Tobacco is a solanachea plant that grows mainly in colonies and for that, the great marine trips of centuries the Eastern hemisphere, also cultivated in Turkey, Russia XVI, XVII and XVIII around the world contributed to and other countries of Europe.20 Columbus and the con-take tobacco and the habit to smoke until the coasts of querors that followed saw it the Indians of the Antillean Asia, Africa and the Australian Continent.18 In several Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 67oriental countries like Japan, Russia, China and Turkey lized by Bayer as substitute of the opium and morphine in tobacco's use was strongly fought initially with drastic the detox programs; its effects as a potent pain killer and measures; for instance, Sultan Murad IV ordered the exe-stimulating effect lead to widespread commercialization cution of numerous smokers and, in 1638, the Chinese au-and only many years later the commercialization for this thorities threatened beheading the tobacco dealers; Turks aim was interrupted.12 The heroin began to become po-got up themselves to the world-wide market of tobacco pular like recreational drug in the United States and En-and became heavy smokers, like the Chinese.18.gland first and, later, in almost the entire world, being The earliest reference of the medicinal properties of sought as the symbol of pernicious effects of drugs.24the cannabis dates from 2700 B.C., when in China was Ecstasy was one of the most popular illegal psycho-used for the treatment of flue, rheumatic malaria, pains tropic drugs back to the past 1980 era.25 One of the most and menstrual upheavals. After that, was widespread used drugs amongst youngsters that although most of throughout history in India, Middle East, South Africa medical references about de origins is methylenedioxy-and South America.21 Hemp (sativa cannabis, Marihua-methamphetamine (MDMA, ecstasy) that makes referen-na) has been cultivated in China for 4,000 years.6 The ces of its development as an appetite suppressor, by the Ancient Greeks, and particularly Galen make references German pharmaceutical company Merck in 1912, it is no-about cannabis. Also, Galen in his De alimentorum facul-thing but a common error.26 Although MDMA had been tatibus (6, 549-550), write about cannabis' seed, compa-developed in 1912 the first known study in humans was red to the seed of agnocastus; jointly with the reference published in 1978, by Shulgin et al. about chemistry, ki-in De simplicium medicamentorum temperamentis ac netics, dosage, and psychotropic effects.27-28 Only in 1984 facultatibus and in De victu attenuante.22 Some of its it was baptized as "Ecstasy" in California, USA.26 very know effects by nowadays where already descript What about cocaine? In America, the Inca empire although being unknown the plethora of effects that are (Andean) produced three annual harvests from cocaine available today (in Galen passages some effects where leaf (erythroxilum cocaine lam) which were used as anal-cited like difficult to digest, cause pain in the stomach, gesic and energizing of daily use, specially due to fatigue migraine, spoils humors and also produced an altered produced by height; in the Aztec society, was also used state of mind in some people, particularly when it was the ingestion of the so called teonanacati fungus and the smoked and not eaten. In equal way, Greek people knew consumption of peyote with religious aims.6 The leaf of about its vapors, and obviously, about its special effects, Cocaine (Erythroxylon Cocaine, of Linnaeus), overco-and the fact that roughly nobody described abuse of this mes its beginnings in the historical knowledge by year stupefacient in a straight line was maybe due to its rarity 2000 B.C., being found artifacts and instruments for its (cannabis was not believed to be originally from Greek) mastication in Chilean and Peruvian coasts; the word or its abnormal consumption.22Cocaine comes from Khoca that means literally "tree" or Cannabis is part of THC drugs (Tetrahydrocanna-"plants",14 and when it emerges in all his splendor in the binols). Its effects are well described: when the drug is pre-Columbian times, locating itself like the center of the smoked the effects appear quicker than when ingested, religious and social system of the Incas, for whom the being the primary effects euphoria, relaxation and chan-plant was a divine gift.29 Other authors states that the use ges in the perception.23 In heavy consumers more promi-of the stimulating cocaine in America is as old as the use nent delusions can occur, time notion are modified, the of the alcohol, opium and the cannabis in the old conti-short term memory is affected, mental processes become nent and Asia, so that cocaine leaves already were chewed confused, the person can forget the contents of conver-in the Andean region from approximately 5,000 B.C.30 sations and be not able to communicate accurately; ul-Erythroxilum cocaine grew at the beginning of wild way timately, other negative effect are paranoia, respiratory but it began to be cultivated in the century X A.C., by the problems, dryness in mouth, cardiac acceleration, psy-Chibcha Indians of Colombia, that later spread it to south, chological dependence and, if the consumer have tenden-being used in sacred rituals and medicine procedures.31. cy to develop neuroses and psychoses, the use of canna-In Inca culture where mastication of Cocaine leaf was bis can unchain the problem.23mainly reserved for aristocracy and the sacerdotal body, Morphine (name in honor to Morfeo, God of the except for sometimes specific rituals or in some initia-dreams), was isolated of the opium at the beginning of te processes, and the own Americus Vespucci in 1499 century XIX by the German Fiedrich William Sertuner is noticed of the behavior of some Indians of Venezuela and happened to replace (along with codeine) the opium coast, apparently raised and without fatigue in spite of in the medical treatments, specially after the introduction the work.14 Before the era of great navigations in century of hypodermic injection like therapeutic, in 1855.2,7 In XVI cocaine was not well-known in other places of the 1874, was created the first semi synthetic opiate, diacetyl-world. When the Spaniards arrived, they were surprised morphine, also well-known as heroin. It was commercia-with the effects of the leaves chewed by the workers. At a 68 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010first moment, by religious reasons, they tried to prohibit substance abuse could have evolved in order to exploit it but later they used it like stimulating in the operation of antiparasitic property of plant toxins, amongst other pos-the silver mines.2 The consumption by American Natives sibilities. Independently of the best hypothesis found, was attacked and condemned in the first celebrated Ec-they suggest more and deeper neurochemichal research clesiastical Assembly in Lima in the year of 1551, once it to explain the apparent tendency for humankind drug was considered to be related to idolatry and witchcraft.32. abuse.34It is praised and recommended by their active principle - Considering the distribution of drugs in natural the cocaine - and their pharmacological effects at the end environments in ancestral ages, if we consider that re-of century XIX, when Sigmund Freud and Halsted and sources were limited and so probably the overactivity Hall, used it in their experiments of psychopharmacology of salient (wanting) behavior. So, there is no reason to and local anaesthesia, respectively.32-33postulate the development of dopaminergic reward corti-Amphetamine is a chemical derivative of ephedri-co-mesolimbic system in terms of a "built-in regulatory ne, synthesized for the first time in 1887 by Rumanian system of salience".35 By that reason, the author postulate chemistry L. Edeleano, which baptized the substance as that factors like genetic and environmental ones could phenilisopropilamine. The experimental medical use of have no consequences in ancient environments, because amphetamines began in 1920. The role of World War II of their limitations. This could be a factor that could have that lead to its administration to the soldiers in a mas-leaved us more vulnerable to addictive behavior, mostly, sive form, with the objective to fight the fatigue and to according to the author, the development of ancient psy-maintain them alert.2 Almost all the armies used them. chotropic plant chemicals.35 For instance, the American army distributed more than We present a table I with some landmarks of evolu-180 million tablets to its combatants; amphetamines also tionary addictive behavior and drug discover.have been used like an agent to improve physical and In the same line, psychotropic drugs could have evol-cognitive performance (doping effects).2ved to present allelochemical reactivity in order to deal LSD was accidentally discovered by Swiss chemis-with threats from herbivores and pathogenic invasions, as try Albert Hoffman in 1938 when it tried to find an ana-if they were an imitation of mammalian neurotransmitter logous substance to stimulate circulatory system, being system, that act like competitive binders, obstructing nor-commercialized by Sandoz factory under the name of mal functioning of central nervous system.34-35 This ideas Delycid, with the alleged objective of facilitate psycho-reinforce that where the evolution of mammalian brains therapy and to fight some upheaval like chronic alcoho-and psychotropic drugs where co-dependent, that is to say lism, sexual anomalies, etc.; when it was verified that that existed an ecological interaction and influenced one the drug produced unforeseeable effects, it was finally another in terms of evolution.34 One set of examples to re-forbidden.6 inforce this hypothesis, but maybe the most striking one is At this point, let us remind the title of this paper: that in the mammalian CNS we found opioid receptors, but Origins of Addictive Behavior: nature or nurture? And the truth is that the body do not provide any natural opioid let us think a little about it.substance by himself (so that could be pretty more logical Some authors present a recent review about the de-that some environmental effect forced the mammalian or-nominated "paradox of drug reward in human evolution" ganism to develop receptors to exogenous opioids).35and the evaluation of the paradox between evolutionary Most of the times, the way to describe the beginnings biology's punishment model and neurobiology's reward of ancient drug utilization is based on the artifacts that re-model.34 The current existing models of drug reward have mains from older eras and is target of the study of the so effectively bypassed the paradox by ignoring the evolved called archeobotany or archaeoethnobotany.36 function of plant drugs and the probable co-evolution of For example, considering hallucinogenic drugs, ha-plant defensive compounds and herbivore nervous sys-llucinogenic plants are most of the times considered as tems. The principal conclusions was that there are some the principal source of psychoactive drugs.37 The authors major assumptions underlying the current evolutionary state that these drugs must be used to reach deep altered reward models that should take into that: a) "drugs are states of consciousness. It's also stated that several inves-an evolutionary novelty; b) humans (and mammals) are tigators believe that this was particularly accurate during inherently vulnerable; c) and hedonic reward best cha-the Tiwanaku empire expansion, surrounding the era of racterizes the psychological and physiological responses 500-1000 A.D., along the Atacama Desert of Chile. In to drug exposure".34 They consider the contradictory evi-equal way, emphasize the roll that artifacts played in those dence that shows that most of abuse drugs are derived conclusions, such as decorated snuffing tablets and tubes, from toxic elements, developed to be toxic and avoid and as well as grave goods during this period ("until now the repeal enemies (e.g Butolin Toxine).34 Also, the authors type of drugs consumed in this paraphernalia has been suggest that, as an hypothesis that the nature of human unclear")37 Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 69About the archeological discovers in Shumla Cave netic factor in facilitation of drug use initiation like in number 5, Rio Grande, Texas, USA, and states that the nicotine,40 alcohol41 and a plethora of drugs. For instance, identification of mescaline, in that sample, strengthens in a study of two groups with more than one thousand fe-the evidence that native North Americans considered male twins, monozygotic and dizygotic, were evaluated and used the psychotropic properties of peyote for at possible association of genetic influence on drug use.42 least 5700 years ago.38 Prior studies have shown that the They found some evidences that genetic influences have utilization of psychotropic drugs in that region of Nor-a say to vulnerability to drug use, and each category of th Mexican and South American border could be dated drugs, apart from hallucinogens, presents distinctive ge-from 8500 BC.39netic influences. The genetic influence of vulnerability There are several studies that stress a possible ge-was superior for heroin than for other drugs.42 In other Tabla 1. Landmarks on addictive behavior (35) aArchaeological records indicate the presence of psychotropic plants and drug use in ancient civilizaons as far back as early hominid species about 200 million years ago. b Roughly 13,000 years ago, the inhabitants of Timor commonly used betel nut (Areca catechu), as did those in Thailand around 10,700 years ago. cAt the beginning of European colonialism, and perhaps for 40,000 years before that, Australian aborigines used nicone from two different indigenous sources: pituri plant (Duboisia hopwoodii) and Nicoana gossel. North and South Americans also used nicone from their indigenous plants N. tabacum and N. rusca. d Ethiopians and northern Africans were documented as having used an ephedrine-analog, khat (Catha edulis), before European colonizaon. e Cocaine (Erythroxylum coca) was taken by Ecuadorians about 5,000 years ago and by the indigenous people of the western Andes almost 7,000 years ago. The substances were popularly administered through the buccal cavity within the cheek. Nicone, cocaine, and ephedrine sources were first mixed with an alkali substance, most oen wood or lime ash, creang a free base to facilitate diffusion of the drug into the blood stream. Alkali paraphernalia have been found throughout these regions and documented within the archaeological record. Although the buccal method is believed to be most standard method of drug administraon, inhabitants of the Americas may have also administered substances nasally, rectally, and by smoking. Many indige-nous civilizaons displayed a view of psychotropic plants as food sources, not as external chemicals altering internal homeostasis. fThe perceived effects by these groups were tolerance to thermal fluctuaons, increased energy, and decreased fague, all advantageous to fitness by allowing longer foraging session as well as greater ability to sustain in mes of limited resources. gThe plants were used as nutrional sources providing vitamins, minerals, and proteins rather than recreaonal psychotropic substances inducing inebriaon. Due to limited resources within ancient environments, mammalian species most probably sought out CNS neurotransmier (NT) substutes in the form of psychotropic allelochemicals, because nutrient NT-precursors were not largely available in the forms of food. Therefore, drugs became food sources to prevent decreased fitness from starvaon and death. It is believed that early hominid species evolved in conjuncon with the psychotropic flora due to constant exposure with one another. This may be what eventually allowed the above civilizaons to use the flora as nutrional substances, therefore increasing both their fitness and viability. 70 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010separated studies including samples of twins of both the idea is that in drug abuse (whether in initiation or sexes, suggest a superior genetic weight in men for vul-in chronic abuse) at least three major factors should be nerability to drug abuse/dependency reaching 60-80% taken into consideration: the psycho emotional subject, of the genetic weight in the development of drug use the environment and the "genetic subject". This could and abuse.43-44 be considered as a Multifactorial Polygenic Heritage. Some authors presented a literature review on family Several studies strongly suggests this for alcohol depen-and in two well known phases of drug addiction treatment dence starting in animal,54 human first-degree relatives and processes: engagement and treatment.45 According of alcoholics,55 adopted Childs from alcoholic and non-to the cited sources, the article highlights the necessity alcoholic biologic parents,56 monozygotic and dizygotic for addict patients to be treated along with their families twins,57 siblings of alcoholics compared with nonalco-(some authors suggest Familiar Therapy) so that adequa-holics in terms of risk factor.58 The same hypothesis has te results could be expected. The importance of socio-been putted for other drugs although at a lower rate of cultural issues can influence institutional treatment and published data. For the importance and clearness of ideas call attention for the necessity that treatment of addict's we transcribe here a part where this point is strongly patients and their families, as well as effective preventive approached:59 action programs.45 These point gains considerable rele-If genetic factors are involved in drug abuse, what vance since it is well known the dependence developed does this mean? First, we must realize that genes do not by intra-uterine via in pregnant mothers that continues directly cause behavior.the use and abuse of drug during pregnancy, with pro-No gene or set of genes, for example, will directly ved deleterious effects for her siblings.46 Some examples cause a person to become a drug abuser or to engage in are the fetal alcohol syndrome,47 neonatal withdrawal drug-taking behavior.syndrome,48 neonatal abstinence,49 effects of pre-natal Instead, genes are segments on chromosomes that exposure by cocaine, amphetamines and heroin,50-51 etc.code for the production of specific proteins (or serve to For example, in a recent study with 1836 subjects regulate the activities of other genes) that are important in tried to "examine substance use and dependence among the control of behavior. If a gene is absent, a protein that cocaine dependent subjects and their siblings compared controls the development or function of a physiological to individuals recruited from the same neighbourhood system may not be produced. In certain cases, the impact and their siblings in order to better understand family may be obvious, as in the case of phenylketonuria, when and neighbourhood contributions to the development of failure of a gene to code for the enzyme responsible for dependence" (p. 14).52 Cocaine dependent subjects came metabolism of phenylalanine results in development of a from treatment centres and community-based subjects severe form of mental retardation. In other cases, however, were sample-matched to cocaine dependent cases, with the impact of genes on behavior may be less obvious but one full sibling for each case and community-based sub-just as real, as when genetic factors produce a tendency ject. The results show a higher risk rate of cocaine and or predisposition to respond in a certain manner. Such other substances use in siblings of cocaine users. Never-is believed to be the influence of genes on a number of theless, the authors conclude that Cocaine dependence behavioral traits and disorders, including alcoholism and is characterized by poly-substance use and dependence. drug dependence. Thus, genes are not the sole determi-Stressing that the prevalence of substance dependence in nant of alcoholism or drug dependence, but their presence the community subjects was higher than reported for the (or absence) may increase the likelihood that a person will general population, they state that cocaine dependent ca-become alcoholic or drug dependent. Second, as the above ses probably live in higher-risk communities, characteri-statement indicates, genes do not act alone in determining zed by an elevated prevalence of substance dependence.52 whether a person will become alcoholic or drug dependent. Although all data presented, many researchers and Our experience in behavioral genetics suggests that both also a great part of social general opinion, support ideas genetic and environmental factors will ultimately be im-from the Institute for Health and Social Policy, from USA, plicated in the etiology of drug abuse. As with alcoholism, that suggest that the most important factors for the initia-simple cause-and effect models will not be sufficient for tion and continuation of drug utilization are societal fac-explaining vulnerability. Rather, various combinations of tors, that could include the tolerance for drug utilization biological and environmental factors are likely to be identi-- perceptions of negative social and health consequences fied that function to attenuate or exacerbate an individual's of the use of these drugs - as well as the availability and likelihood for becoming drug dependent. Just because an the ways the drugs are set in the market.53 In our opinion, individual has a genetic tendency for developing drug de-this type of hypothesis appears not to consider the possi-pendence does not mean he or she will necessarily develop ble inner predisposition for drug consumption, based on the disorder. Whether the disorder develops will ultimately the well known vulnerability model. Generally speaking, depend on environmental influences. Certain types of en- Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 71vironmental influences are believed to be necessary for a forced treatment during incarceration?),61-62 the social con-genetically vulnerable person to develop drug dependence. trol strategies,63 direct effects in ruining careers,64 and For example, one environmental influence that is essen-in homelessness,65 disruptive behaviours,66 other health tial to the development of the disorder is that an individual consequences, as altered sates of cortical activation and must initially engage in drug-taking behavior. Thus, while neuronal malfunction,67-69 neuropsychological deficits,70-72 a person may be genetically loaded for drug dependence, and so on.if drugs are never used, that person will never run the risk Furthermore, the complete disaster of scare stra-of becoming drug dependent. The presence of other envi-tegies in drug use prevention is very important.73 Also, ronmental factors in the development of drug dependence the role of media messages about addictive behaviour (e.g., drug availability, the manner in which a person uses and deleterious substances or habits should strongly be drugs) is also suspected. These may include environmen-revised.74 The future, as well as the real present, will pro-tal influences that operate within the immediate milieu bably force us to accept and implement more educative (e.g., family and peer influences) or more broadly (e.g., strategies than scaring or punishing strategies to avoid cultural factors). Third, genes may influence a person's individual drug use initiation. tendency to develop drug dependence in many ways. Most The answer to our work question: Addiction - nature people believe that genetic influences operate by produ-or nurture? is, naturally, not available by now. However cing an aberrant or idiosyncratic biological response to one thing seems to make sense to us. At the beginning drugs. For example, genes may make some people more of mankind drug use, most of then appear to be started (or less) sensitive to a drug's effect, or they may produce a as a recreational use, as part of rituals or cultural panto-qualitatively different drug effect in some people than in minas. Furthermore, generations after generations, drugs others. While this may indeed be the case, it is important utilization, or if we prefer, addictive behaviour, became to recognize that there are mechanisms other than pharma-probably coded in our inheritance. Understanding the cological mechanisms that may account for genetic effects. phenomena of Multifactorial Polygenic Heritage (the in-One nonpharmacological mechanism is that genes may de-teractions of the psycho emotional subject, the environ-termine personality characteristics that increase the pro-ment and the "genetic subject") could probably be very bability of drug abuse. For example, a person may inherit helpful in preventing and treating addictive behavior.a sociopathic personality that increases the likelihood of contact and experimentation with drugs.ReferencesCultural factors may in part be genetically determi-1. Levine H. The Discovery of Addiction: Changing ned, which may increase the likelihood of drug use that will Conceptions of Habitual Drunkenness in America. eventually lead to increased rates of drug dependence.59J Studies Alcohol. 1979; 15:493-506.Of course we do not lose of sight the social impact of 2. Courtwright D. Dark Paradise: Opiate Addiction in drug abuse, like the one, for example, related with crime. America Before 1940. Cambridge: Harvard Univer-For instance, substance abuse is habitually found in vio-sity Press; 1982. lent offenders.60 He mentions data from DSM-IV (1994), 3. Room R. The Cultural Framing of Addiction. Janus "more than one-half of all murderers and their victims are Head 2003; 6(2):221-34. believed to have been intoxicated with alcohol at the time 4. Mathew VM. Alcoholism in biblical profecy. Alco-of the murder".60hol Alcohol 1992; 27(Jan. 1):89-90. In terms of etiology, most attention in the drug abu-5. Marques ACPR. Alcohol use and the evolution of se field has been focused on psychosocial factors that other drugs dependence concept and treatment. Re-contributes to drug experimentation by adolescents.59vista IMESC 2001;(3):73-86.A variety of community factors and individual vul-6. Ganzenmuller C, Escudero JF, Vallina JF. Drogas, nerabilities pressure drug abuse patterns and trends wi-sustancias psicotropicas y estupefacientes. Barcelo-thin a geographic area and throughout a particular phase na: Ed. Bosch; 1997.and, contrasting with infectious diseases, drug abuse, 7. Arriazu JP, Valladolid GR. Historia General de las and what kind of drugs are used by whom, is more pre-drogas, in Manual de drogodependencias para en-judiced by social factors rather than biological ones. The fermeria. Madrid: Diaz de Santos; 2002.author states, on the other hand, once subjects start on 8. Do Vale NB, Delfino J. Nine Biblical Anesthetic drug abuse, their brains and bodies suffers some altera-Premises. Rev Bras Anestesiol 2005; 53 (1):127-36.tions and biological and physiological factors happen to 9. San Vicente LE. Resena de las adicciones en Mexi-be added as important factors.53co. Primera parte. Mexico, DF: Division de Educa-Despite everything that was stressed in this paper, the cion Continua - Facultad de Psicologia. Universidad actual implications of drugs in terms of personal and so-Nacional Autonoma de Mexico; 2006.cial levels are shocking. The prison reality (punishment vs. 10. Jordan DH. An Offering of Wine: An Introductory 72 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010exploration of the role of wine in the Hebrew Bi-tomimetic activity. `QuaSAR'. Res Monograph. Na-ble and ancient Judaism through the examination of tional Institute of Drug Abuse 1978; 20:8-15. the semantics of some keywords. [Thesis Doctor of 29. Garcia Diaz F. El consumo de drogas en los pueblos Philosophy (PhD)]. Department of Semitic Studies/precolombinos. Rev Electronica de Ciencia Penal y University of Sydney; 2002.Criminologia. 4-r3; 2002. [Acceso en: 08 Mayo 2008].11. Philips R. Uma breve historia do vinho. Rio de Ja-Disponible en linea: http:/ criminet.ugr.es/recpc neiro: Record; 2003.30. Pascual Pastor F. Aproximacion historica de la Cocai-12. Escohotado A. Historia Elemental de las drogas. na. De la Coca a la Cocaina. Cocaina - Rev Encuentro Barcelona: Editorial Anagrama; 2005. Nacional para Profesionales. 2002; 13 (2):7-21. 13. Hodgson B. Opio, un retrato del demonio celestial. 31. Conyer Tapia R. La cocaina, origen, botanica e his-Madrid: Ed. Tuner; 2004. toria, in Las adicciones: dimension, impacto y pers-14. Cabrera Forneiro J. Las drogas de abuso como subs-pectivas. Mexico: Manual Moderno; 2001.tancias psicotropicas y neuro toxicas: breve historia 32. Castano GA. Cocainas fumables en Latinoamerica. de las drogas. [Acceso 08 Mayo 2008]. Disponible Adicciones 2000; 12 (4):541-50. en linea: http://www.doctorjosecabrera.es/pdf/arti-33. Querol M. Freud, la Coca y la Cocaina. En: Psi-culo10.pdf .coactiva. Rev Cientifica. Centro de Informacion y 15. Cabrera Bonet R, Cabrera Forneiro J. Las drogas de Educacion para la Prevencion del Abuso de Drogas abuso: Un reto sanitario. Madrid: Universidad Pon-1996; 14(10):81-101. tificia Comillas; 1994.34. Sullivan RJ, Hagen EH, Hammerstei P. Revea-16. Cabrera Forneiro J, Fuertes Rocian JC. Psiquiatria y ling the paradox of drug reward in human evolu-Derecho. Madrid: Ed. Cauce; 1997.tion. Proceedings of the The Royal Society; 2008. 17. Blazquez Miguel J. Brujas e inquisidores en la Ame-doi:10.1098/rspb.2007.1673. rica colonial (1569-1820). Madrid: Espacio, Tiempo 35. Saah T. The evolutionary origins and significance y Forma; 1994. Serie IV, i-i. Moderna. 7, 71-98.of drug addiction. Harm Reduction J. 2005; 2:8.[Ac-18. Sagregra JE. El tabaco. Droga magica, medicamen-cess 16 April 2008]. Available from: http://www.to y veneno. O F F A R M. 2006; 25: 98-104.harmreductionjournal.com/content/2/1/8.19. Sanjuan MA, Lopez PI. Todo sobre las drogas lega-36. Schultes RE, von Reis S. Ethnobotany: Evolution of a les e ilegales. Madrid: Dykinson; 1992.Discipline. Portland, Oregon: Dioscorides Press; 1995.20. Sabido RC, Cicero LS, Fernandez PC. El consumo 37. Ogalde JP, Arriaza BT, Soto EC. Prehistoric psy-de tabaco. Desde los mayas al siglo XXI Algunos chotropic consumption in Andean Chilean mum-puntos de vista. Rev Instituto Nacional de Enferme-mies. [Access 18 April 2007]. Nature Precedings: dades Respiratorias 2003; 16:103-7.hdl:10101/npre.2007.1368.1. Available from: http:/21. Lobo AO. Cannabis: medicina o droga? Psiquiatria precedings.nature.com/documents/1368/version/1.Publica 1998; 10:68-72.38. El-Seedi HR, De Smet PAGM, Beck O, Possnert G, 22. Arata L. Nepenthes and Cannabis in Ancient Gree-Bruhn JG. Prehistoric peyote use: Alkaloid analysis ce. Janus Head 2004;7(1):34-49. and radiocarbon dating of archaeological specimens 23. Mikosz JE. Substancias Psicoativas e Religiao. of Lophophora from Texas. J Ethnopharmacol 2005; FPOLIS : Cad Pesqui Interdiciplinar Cienc Huma-101:238-42.na; 2006.39. De Smet PAGM, Bruhn JG. Ceremonial peyote use 24. Gamella J. Drogas: la logica de lo endovenoso.Rev and its antiquity in the Southern United States. Her-Claves de la Razon Practica 1991; 18: 72-80.balGram 2003; 53:30-3.25. Freudenmann R. W. `Ecstasy', the drug of the te-40. Kandel DB, Hu M-C, Griesler PC, Schaffran C. On chno generation: clinical aspects. Nervenheilkunde the development of nicotine dependence in adolescen-2005; 24:557-72.ce. Drug and Alcohol Dependence 2007; 91:26-39. 26. Freudenman RW, Oxler F, Bernschneider-Reif S. 41. Rose RJ. A development behaviour-genetic pers-The Origin of MDMA (ectasy) revisited: the true pective on alcoholism risk. Alcohol Health Res Wld story reconstructed from the original documents. 1998; 22(2):131-43.Addiction 2006; 101(9):1241-5.42. Tsuang MT, Lyons MJ, Meyer JM, Doyle T, Eisen 27. Shulgin AT, Nichols DE. Characterization of three SA, Goldberg J, et al. Co-occurrence of abuse of new psychotomimetics. In: Stillman R. C, Willette different drugs in men. Arch Gen Psychiatry 1998; RE, editors. The psychopharmacology of the hallu-55:967-72.cinogens . New York: Pergamon Press; 1978.43. Kendler K, Prescott C. Cocaine use, abuse and de-28. Anderson GM. III, Braun G, Braun U, Nichols DE, pendence in a population based sample of female Shulgin A. T. Absolute configuration and psycho-twins. Br J Psychiatry 1998; 173:345-50. Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 73

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Origins of Addictive Behavior: A Nature Heritage or a Neuropsychiatric Nurtured.. read more